,,ii  #aagth ,,congress  #b;d ,session  
,s4 #cifd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #cj1    
#bjbb,mr4 ,moran introduced the         
following bill2 which was read twice and
 referred to the ,committee on          
,veterans' ,affairs  ,a ,,bill  ,to     
amend title #ch1 ,united ,states ,code1 
to modify the family caregiver program  
of the ,department of ,veterans ,affairs
 to include services related to mental  
health and neurological disorders1 and  
for other purposes4  #a4 ,short title   
,this ,act may be cited as the          
,reinforcing ,enhanced ,support through 
,promoting ,equity for ,caregivers ,act 
of #bjbb or the ,,respect ,act of #bjbb4
  #b4 ,modification of family caregiver 
program of ,department of ,veterans     
,affairs to include services related to 
mental health and neurological disorders
  7a7 ,in general ,section #agbj;,g of  
title #ch1 ,united ,states ,code1 is    
amended-- 7#a7 in subsection 7a7-- 7,a7 
in paragraph 7#b77;,c7-- 7i7 in clause  

7iii71 by striking 2 or and inserting a 
semicolon2  7ii7 by redesignating clause
 7iv7 as clause 7v72 and  7iii7 by      
inserting after clause 7iii7 the        
following new clause 7iv73  7iv7 a      
diagnosed mental illness or history of  
suicidal ideation within the past three 
years that puts the veteran at risk of  
self-harm2 or  2  7,b7 in paragraph     
7#c7-- 7i7 in subparagraph              
7,a77ii77,,vi7-- 7,i7 in item 7aa71 by  
striking 2 and and inserting a          
semicolon2  7,,ii7 in item 7bb71 by     
striking the period at the end and      
inserting 2 and2 and  7,,iii7 by adding 
at the end the following new item3  7cc7
 mental health treatment and counseling 
services4  2 and  7ii7 in subparagraph  
7,c7-- 7,i7 in clause 7iii7-- 7aa7 in   
the matter preceding subclause 7,i7--   
7,,aa7 by striking or regular           
instruction and inserting 1 regular     
instruction2 and 7,,bb7 by inserting or 
a diagnosis of mental illness or history
 of suicidal ideation that puts the     

veteran at risk of self-harm under      
paragraph 7#b77;,c77iv71 before the     
,secretary shall2  7bb7 in subclause    
7,,ii71 by inserting before the period  
at the end the following3 1 or          
assistance relating to the risk of      
self-harm of the veteran1 as the case   
may be2 and  7cc7 in subclause 7,,iii71 
by striking such supervision1           
protection1 or instruction to the       
veteran and inserting to the veteran    
such supervision1 protection1 or        
instruction1 or assistance relating to  
the risk of self-harm of the veteran1 as
 the case may be2 and  7,,ii7 by adding 
at the end the following new clauses3   
7v7 7,i7 ,for purposes of determining   
the amount and degree of personal care  
services provided under clause 7i7 with 
respect to a veteran described in       
subclause 7,,ii71 the ,secretary shall  
take into account relevant documentation
 evidencing the provision of personal   
care services with respect to the       
veteran during the preceding three-year 

period4  7,,ii7 ,a veteran described in 
this subclause is a veteran whose need  
for personal care services as described 
in paragraph 7#b77;,c7 is based in whole
 or in part on-- 7aa7 a diagnosis of    
mental illness or history of suicidal   
ideation that puts the veteran at risk  
of self-harm under clause 7iv7 of such  
paragraph2 or  7bb7 a neurological      
disorder4  2 and  7,c7 by adding at the 
end the following new paragraph3  7#ad7 
,the ,secretary shall establish a       
process and requirements for clinicians 
of facilities of the ,department-- 7,a7 
to document incidents in which an       
eligible veteran presents at such a     
facility for treatment for an emergent  
or urgent mental health crisis or an    
eligible veteran is assessed by such a  
clinician to be at risk for suicide2 and
  7,b7 provide such documentation to the
 program established under paragraph    
7#a74  2 and  7#b7 in subsection 7d71 by
 adding at the end the following new    
paragraph3  7#e7 ,the term qualified    

mental health professional means a      
psychiatrist1 psychologist1 licensed    
clinical social worker1 psychiatric     
nurse1 or other licensed mental health  
professional as the ,secretary considers
 appropriate4  4  7b7 ,timing for       
establishment of requirements and       
processes  7#a7 ,report ,not later than 
#ahj days after the date of the         
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall-- 7,a7      
establish the process and requirements  
required under paragraph 7#ad7 of       
section #agbj;,g7a7 of title #ch1       
,united ,states ,code1 as added by      
subsection 7a77#a77;,c72 and  7,b7      
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a           
description of such process and         
requirements4  7#b7 ,certification  7,a7
 ,in general ,not later than one year   
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       

,affairs shall require all clinicians of
 facilities of the ,department to       
certify to the ,secretary that the      
clinician understands the process and   
requirements established under paragraph
 7#a77;,a74  7,b7 ,facilities of the    
,department defined ,in this paragraph1 
the term facilities of the ,department  
has the meaning given that term in      
section #agja of title #ch1 ,united     
,states ,code4  #c4 ,requirements       
relating to evaluations1 assessments1   
and reassessments relating to           
eligibility of veterans and caregivers  
for family caregiver program  7a7 ,in   
general ,subsection 7a7 of section      
#agbj;,g of title #ch1 ,united ,states  
,code1 as amended by section #b7;a77#a71
 is further amended by adding at the end
 the following new paragraphs3  7#ae7   
7,a7 ,for purposes of conducting        
evaluations and assessments to determine
 eligibility of a veteran and caregiver 
for the program established under       
paragraph 7#a7 or conducting            

reassessments to determine continued    
eligibility for such program1 the       
,secretary shall-- 7i7 take into account
 relevant documentation and medical     
records generated by non-,department    
health care providers1 including        
qualified mental health professionals   
and neurological specialists2  7ii7 if  
the caregiver of the veteran claims that
 the serious injury or need for personal
 care services of the veteran as        
described in paragraph 7#b7 is based in 
whole or in part on psychological trauma
 or another mental disorder1 ensure--   
7,i7 a qualified mental health          
professional that treats the veteran    
participates in the evaluation process2 
and  7,,ii7 a qualified mental health   
professional participates in the        
assessment or reassessment process2 and 
7iii7 if the caregiver of the veteran   
claims that the serious injury or need  
for personal care services of the       
veteran as described in paragraph 7#b7  
is based in whole or in part on a       

neurological disorder1 ensure-- 7,i7 a  
neurological specialist that treats the 
veteran participates in the evaluation  
process2 and  7,,ii7 a neurological     
specialist participates in the          
assessment or reassessment process4     
7,b7 7i7 ,the ,secretary shall establish
 an appropriate time limit during a     
#bd-;hour period for the active         
participation of a veteran in an        
evaluation1 assessment1 or reassessment 
to determine eligibility of the veteran 
for the program established under       
paragraph 7#a74  7ii7 ,in determining an
 appropriate time limit for a veteran   
under clause 7i71 the ,secretary shall--
 7,i7 take into consideration necessary 
accommodations for the veteran stemming 
from the disability or medical condition
 of the veteran2 and  7,,ii7 consult    
with the primary care provider1         
neurological specialist1 or qualified   
mental health professional that is      
treating the veteran4  7,c7 ,the        
,secretary shall not require the        

presence of a veteran during portions of
 an evaluation1 assessment1 or          
reassessment to determine eligibility of
 the veteran for the program established
 under paragraph 7#a7 that only require 
the active participation of the         
caregiver4  7,d7 7i7 ,the ,secretary    
shall make reasonable efforts to assist 
a caregiver and veteran in obtaining    
evidence necessary to substantiate the  
claims of the caregiver and veteran in  
the application process for evaluation1 
assessment1 or reassessment for the     
program established under paragraph     
7#a74  7ii7 7,i7 ,as part of the        
assistance provided to a caregiver or   
veteran under clause 7i71 the ,secretary
 shall make reasonable efforts to obtain
 relevant private records that the      
caregiver or veteran adequately         
identifies to the ,secretary4  7,,ii7   
,whenever the ,secretary1 after making  
reasonable efforts under subclause 7,i71
 is unable to obtain all of the relevant
 records sought1 the ,secretary shall   

notify the caregiver and veteran that   
the ,secretary is unable to obtain      
records with respect to the claim1 which
 shall include-- 7aa7 an identification 
of the records the ,secretary is unable 
to obtain2  7bb7 a brief explanation of 
the efforts that the ,secretary made to 
obtain such records2 and  7cc7 an       
explanation that the ,secretary will    
make a determination based on the       
evidence of record and that this clause 
does not prohibit the submission of     
records at a later date if such         
submission is otherwise allowed4        
7,,iii7 ,the ,secretary shall make not  
fewer than two requests to a custodian  
of a private record in order for an     
effort to obtain such record to be      
treated as reasonable under subclause   
7,i71 unless it is made evident by the  
first request that a second request     
would be futile in obtaining such       
record4  7iii7 ,under regulations       
prescribed by the ,secretary1 the       
,secretary-- 7,i7 shall encourage a     

caregiver and veteran to submit relevant
 private medical records of the veteran 
to the ,secretary to substantiate the   
claims of the caregiver and veteran in  
the application process for evaluation1 
assessment1 or reassessment for the     
program established under paragraph 7#a7
 if such submission does not burden the 
caregiver or veteran2 and  7,,ii7 may   
require the caregiver or veteran to     
authorize the ,secretary to obtain such 
relevant private medical records if such
 authorization is required to comply    
with ,federal1 ,state1 or local law4    
7#af7 7,a7 ,the ,secretary1 in          
consultation with a health care         
provider1 neurological specialist1 or   
qualified mental health professional    
that is treating a veteran1 shall waive 
the reassessment requirement for the    
veteran for participation in the program
 established under paragraph 7#a7 if--  
7i7 the serious injury of the veteran   
under paragraph 7#b7 is significantly   
caused by a degenerative or chronic     

condition2 and  7ii7 such condition is  
unlikely to improve the dependency of   
the veteran for personal care services4 
7,b7 ,the ,secretary shall require a    
health care provider1 neurological      
specialist1 or qualified mental health  
professional that is treating a veteran 
to annually certify the clinical        
decision of the provider1 specialist1 or
 professional under subparagraph 7,a74  
7,c7 ,the ,secretary may rescind a      
waiver under subparagraph 7,a7 with     
respect to a veteran and require a      
reassessment of the veteran if a health 
care provider1 neurological specialist1 
or qualified mental health professional 
that is treating the veteran makes a    
clinical determination that the level of
 dependency of the veteran for personal 
care services has diminished since the  
last certification of the clinical      
decision of the provider1 specialist1 or
 professional under subparagraph 7,b74  
4  7b7 ,definition ,subsection 7d7 of   
such section1 as amended by section     

#b7;a77#b71 is further amended-- 7#a7 by
 redesignating paragraphs 7#d7 and 7#e7 
as paragraphs 7#e7 and 7#f71            
respectively2 and  7#b7 by inserting    
after paragraph 7#c7 the following new  
paragraph 7#d73  7#d7 ,the term         
neurological specialist means a         
neurologist1 neuropsychiatrist1         
physiatrist1 geriatrician1 certified    
brain injury specialist1 neurology      
nurse1 neurology nurse practitioner1    
neurology physician assistant1 or such  
other licensed medical professional as  
the ,secretary considers appropriate4  4
  #d4 ,requirements relating to         
provision of grants for assistance to   
family caregivers of veterans  7a7      
,distribution of grants ,section        
#agbj;,g7a77#c7 of title #ch1 ,united   
,states ,code1 is amended by adding at  
the end the following new subparagraph3 
7,e7 7i7 ,the ,secretary shall          
distribute grants provided under        
subparagraph 7,a77ii77,,vi7 to entities 
eligible for the provision of such a    

grant in geographically dispersed areas4
  7ii7 ,in providing grants to entities 
under subparagraph 7,a77ii77,,vi71 the  
,secretary shall provide equal          
consideration to national1 regional1 and
 local organizations1 in an effort to   
adequately serve individuals in need of 
services provided pursuant to such a    
grant4  4  7b7 ,grant program           
requirements  7#a7 ,rulemaking ,not     
later than #ahj days after the date of  
the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall  
begin the rulemaking process to         
establish a grant program under each of 
items 7aa71 7bb71 and 7cc7 of section   
#agbj;,g7a77#c77;,a77ii77,,vi7 of title 
#ch1 ,united ,states ,code1 as amended  
by section #b7;a77#a77;,b77i71 to       
provide grants under such items4  7#b7  
,report  7,a7 ,in general ,not later    
than one year after the date on which   
the first grant is provided after the   
date of the enactment of this ,act under
 a grant program established under      

paragraph 7#a71 the ,secretary shall    
submit to the ,committee on ,veterans'  
,affairs of the ,senate and ,committee  
on ,veterans' ,affairs of the ,house of 
,representatives a report on the        
provision of grants under each such     
program4  7,b7 ,elements ,the report    
required by subparagraph 7,a7 shall     
include the following3 7i7 ,an          
assessment of the effectiveness of the  
grant programs established under        
paragraph 7#a71 including-- 7,i7 the    
number of individuals who benefitted    
from each grant program in each         
,veterans ,integrated ,service ,network 
of the ,department of ,veterans         
,affairs2 and  7,,ii7 an assessment of  
the effectiveness of increasing         
engagement by individuals eligible for  
such programs in mental health care     
treatment and services1 financial       
planning services1 and legal services in
 each ,veterans ,integrated ,service    
,network4  7ii7 ,a list of recipients of
 grants under each such program and     

their partner organizations1 if         
applicable1 that delivered services     
funded by the grant and the amount of   
such grant received by each recipient   
and partner organization4